Metformin is a commonly used drug for diabetes mellitus, preferred for type 2 diabetes mellitus that is ineffective with simple dietary control and physical exercise therapy, especially for obese patients and patients with hyperinsulinemia. Metformin is able to lower blood sugar by improving insulin resistance in the patient's body. Metformin not only has the effect of lowering blood sugar, but also has the effect of lowering body weight and regulating blood lipids.

While metformin does not normally induce hypoglycemia, it can induce some gastrointestinal reactions, and it is best not to use metformin in patients with poor liver and kidney function to avoid accumulation of the drug and aggravate the damage to the body.

What do I need to pay attention to when taking metformin?

1, under the guidance of a doctor: taking metformin drugs must be under the guidance of a doctor to take, but also pay attention to the contraindications of metformin, such as metformin allergy patients, patients with diabetic ketoacidosis, patients with hepatic and renal insufficiency, pregnancy and lactation of women are not allowed to take.

2, start from a small dose: metformin should be taken from a small dose, the minimum dose is from 0.25 grams, 3 times a day to start, but also need to carry out blood glucose monitoring, according to the blood glucose to adjust the dose of medication. Adjust the dose of metformin should also be adjusted under the guidance of a doctor, and the maximum dose a day should not exceed 2 grams.

3, take after meals: metformin needs to be taken during or after meals, which can reduce the irritation of metformin on the gastrointestinal tract. The food in the gastrointestinal tract after meals can reduce the direct irritability of metformin to the gastrointestinal tract, and can play a role in protecting the gastrointestinal tract and reducing adverse reactions.

4, taking metformin drugs to avoid drinking alcohol: taking metformin drugs at the same time to avoid drinking alcohol, alcohol has a damaging effect on the liver, taking metformin at the same time drinking alcohol, will inhibit gluconeogenesis and lead to hypoglycemia.

5, long-term use of metformin, the need for appropriate supplementation of vitamin B12: long-term use of metformin, will reduce the body's absorption of vitamin B12, resulting in its deficiency, so long-term use of metformin patients, the need for appropriate supplementation of vitamin B12.

What are the circumstances that need to be discontinued metformin?

Most diabetic patients need medication to lower their blood sugar, and metformin is also the drug of choice for many diabetic patients. Diabetic patients need to take the drug for life, but they need to stop taking it in some special cases, let's look at it together.

1, the emergence of liver and kidney function abnormalities, the need to stop

While metformin is not metabolized by the liver, about 90% excreted by the kidneys, for diabetic patients, metformin's liver and kidney toxicity is very small. However, when liver and kidney function are abnormal, it is necessary to consider discontinuing metformin, because continuing to use metformin when liver and kidney function are abnormal is likely to lead to lactic acidosis in the body.

Whether to stop metformin is based on serum creatinine, men: serum creatinine ≥ 1.5 mg / dl; women: serum creatinine ≥ 1.4 mg / dl. or creatinine clearance abnormalities need to be discontinued.

2, coronary angiography need to stop using metformin

Coronary artery disease patients to see clearly the situation of the heart blood vessels, need to carry out coronary angiography, in the coronary angiography before, if you take metformin, need to stop using three days before coronary angiography. Because coronary angiography, you need to inject a contrast agent into the patient's body, the contrast agent contains iodine substances, iodine excretion pathway is the same as metformin, are excreted from the kidneys.

If metformin and iodine are used together, it increases the burden on the kidneys, and metformin excretion is impaired, and it is easy to accumulate toxicity. So you need to stop using metformin for 3 days before using iodine contrast agent. Although some experts believe that the excretion of metformin in people with normal kidney function will not be affected by iodine agents, but for their health, it is best to stop the drug for 3 days.

3, intolerable adverse reactions

When intolerable adverse reactions occur after taking metformin, etc., you need to stop and replace other drugs. For example, allergic reactions, or severe gastrointestinal reactions, you need to consider stopping the drug, replace other hypoglycemic drugs to control blood sugar.

4, pregnant need to stop using metformin

Metformin on pregnant women in the end how much impact, there is no clear results of the study, for safety reasons, if diabetic patients in the process of taking metformin, found that they are pregnant, then you need to stop taking it, under the guidance of the doctor, the use of other pregnant women are relatively safe insulin to control blood glucose.

5, vitamin B12 severe deficiency

Long-term use of metformin may cause a decline in vitamin B12 levels, because metformin alters small intestinal peristalsis, stimulates intestinal bacterial overgrowth, and competitively inhibits the absorption of vitamin B12. Patients taking metformin for a long period of time should have their vitamin B12 levels tested once a year and supplemented appropriately if they are deficient. If the deficiency is severe enough to cause a range of symptoms, consider discontinuing the medication.

In addition, patients suffering from certain serious diseases such as suffering from severe trauma, severe heart failure or infection, this time it is also best to stop using metformin. Some early diabetic patients, after taking metformin for a period of time, the blood sugar can be stabilized in a certain level range. At this time, you can gradually reduce the amount, through diet control, exercise, weight loss, lifestyle changes and other interventions, blood glucose is stable, and there is no sign of rebound, you can consider discontinuing metformin, but you need to do it under the guidance of a doctor, and closely monitor blood glucose.